Recurrence after Endoscopic Resection of Submucosal Invasive Colorectal Cancer Yuji Inoue 1 , Toru Tezuka 1 , Tomoaki Shinohara 1 , Makoto Saida 1 , Masashi Ito 1 1Institute of Gastroenterology, Tokyo Women's Medical University Keyword: 大腸sm癌 , 内視鏡摘除術 , 局所再発 , リンパ節再発 , 血行性転移再発 pp.1719-1729
Published Date 2004/12/25
DOI https://doi.org/10.11477/mf.1403100596
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 We analyzed 7 cases of recurrence after endoscopic resection of submucosal invasive colorectal cancer.

 1 ) Local and lymph node recurrence

 Two patients had local recurrence, 1 patient had local and lymph node recurrence and 1 patient had lymph node recurrence. The recurrence occurred 4~48 months (mean 20.3 months) after endoscopic resection. Two patients who had local recurrence were able to undergo endoscopic resection again, 1 patient who had local and lymph node recurrence underwent surgical bowel resection, and 1 patient who had lymph node recurrence underwent transsacral tumor resection. Curative resection was accomplished in all 4 patients.

 2 ) Distant metastasis

 Two patients had liver metastasis and 1 patient had liver, lung and bone multiple metastases. The recurrence occurred 6~60 months (mean 25.3 months) after endoscopic resection. Two of 3 patients underwent additional surgical bowel resection after endoscopic resection, and 2 patients who had liver metastasis alone were able to receive curative hepatic resection.

 Therefore, it is important to resect the recurrence of submucosal invasive colorectal cancer early by careful follow-up. It is important to observe the scar of endoscopic resection, particularly we should pay attention to findings like submucosal tumor for diagnosing local and lymph node recurrence by colonoscopy, and it is necessary for patients who have undergone endoscopic piecemeal resection to be followed up carefully. It is often difficult to predict distant metastasis, so the measurement of serum CEA and abdominal ultrasonograghy should be performed.

 1) Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo

Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.


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